 |
Indication & Dosage |
| |
| |
| Oral |
| TREATMENT OF SCHIZOPHRENIA |
Adult:
As hydrochloride: ≥ 18 yr: Initially 20 mg bid, increase if necessary at intervals of not < 2 days. Max: 80 mg bid. Maintenance: 20 mg bid.
Elderly: Lower initial dose with slow titration and close monitoring. |
| |
| Oral |
| MANIA |
| Adult:
Initially, 40 mg bid, increased to 60-80 mg bid on 2nd day. Adjust dose according to tolerance level.
Elderly: Lower initial dose with slow titration and close monitoring. |
| |
| Intramuscular |
| ACUTE AGITATION IN PATIENTS WITH SCHIZOPHRENIA |
| Adult:
As mesilate: ≥18 yr: 10-20 mg, repeat every 2-4 hr. Max: 40 mg daily. Do not use >3 consecutive days.
Elderly: Lower initial dose with slow titration and close monitoring. |
|
| |
|
| Administration |
Should be taken with food. |
| |
|
| Precautions |
Patients predisposed to significant electrolyte disturbances, esp hypokalaemia, should have a baseline serum potassium and magnesium screening performed and corrected before treatment. CNS depression; cerebrovascular disease and significant CV illness; history of seizures; conditions that decrease seizue threshold; predisposition to hypotension; patients at risk of aspiration pneumonia; Parkinson's disease; renal impairment (IM); hepatic impairment; pregnancy. Discontinue if persistent QTc measurements >500 msec. May impair ability to drive or operate machinery. Monitor ECG in patients who shows symptoms of torsades de pointes (e.g. syncope, dizziness, palpitations). Monitor serum electrolytes if on concurrent diuretic therapy. Monitor glucose levels in DM or patient at risk of developing DM. |
| |
|
Potentially Life-threatening
Adverse Drug Reactions |
Somnolence, respiratory tract disorders, akathisia, extrapyramidal syndrome, tardive dyskinesia, hyperglycaemia, dizziness, dystonia, headache, GI disturbances, asthenia, agitation, rash, urticaria, visual disturbances, prolonged QT interval, orthostatic hypotension, increased prolactin levels, weight gain, sexual dysfunction, hyperlipidaemia, seizures. |
| |
|
| Adverse Drug Reactions |
Blood dyscrasias, neuroleptic malignant syndrome. |
| |
|
| Interactions |
Increased risk of torsades de pointes with drugs that prolong QT interval e.g. dofetilide, quinidine, sotalol, and other Class Ia and III antiarrhythmics, moxifloxacin, pimozide, sparfloxacin, thioridazine. Antagonistic effect with levodopa and dopamine antagonists. Additive hypotensive effect with antihypertensives. Additive sedative effects with other CNS agents, alcohol. Grapefruit juice may increase serum concentration. Increased CNS depression with kava kava, chamomile. Possible decrease of ziprasidone concentration with St John's Wort. |
| |
|
|
|
